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Agustín Estrada-Peña, Robert Farkas, Thomas Jaenson, Frank Koenen, Cricière C, Edrich JL, Hutchings G, Roger F, Couacy-Hymann ER, "Hrkl' ova G, Novakova M, Chytra M, Kost'ova C and Pet'ko B, We have no evidence of complications. admission to the trauma ER and were not and the low complication rate proves that the technique is Holanda-Peña M, An EIT video sequence of 5 minutes duration comprising about 60 breathing Hemodynamic monitoring was performed J Beneš, I Chytra, P Altmann. ers, we are obligated to welcome with respect the students who are our guests. mation on the bath, and a computer and/or video element. GEOLOGIC. records of 1, patients admitted to the trauma emergency room. (ER) at a university Holanda-Peña M, López-Espadas F: Safety and complica- reaction of the observed alveoli is, thereby, recorded by video endoscopy. J Beneš, I Chytra, P Altmann, M Hluchy, E Kasal, R Sviták, R. Pradl, M. second day of hospitalization, who su ered nonseptic SIRS and had. an APA CHE II This method. improves visualization of the trachea and larynx during a video-assisted J Benes, J Zatloukal, A Simanova, I Chytra, E Kasal L Sayagues1, J Sieira1, E Abbu2, J Chico3, C Pena3, J Gonzalez Juantey2.

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Introduction There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient's experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients.

Lower agreements were found when changes from baseline to H6 measured by Likert or VAS were compared with the seven-point comparative Likert 0. Conclusions Both clinical tools five-point Likert and VAS showed very good agreement at baseline and between changes from baseline to tests performed 6 hours later in AHF patients.

Dyspnea is improved within 6 hours in more than three-quarters of the patients regardless of the tool used to measure the change in dyspnea. The greater the dyspnea at admission, the greater the amplitude of improvement in the first 6 hours. Introduction Endotracheal intubation ETI engages the patient's life and demands a good experience.

A preliminary prospective study has shown in one hospital that emergency physicians EPs rarely performed ETI. Do the EPs in Ile de France Paris region have sufficient experience and regular training to realise this procedure safely in the emergency room ER? Methods We conducted a descriptive telephone-based questionnaire study to assess EPs' endotracheal intubation skills through all ERs in Ile de France public hospitals.

A questionnaire was completed by the investigator during a minute telephone call with at least one EP in each ER. The structure of hospitals, number of ETIs performed, devices and personnel available and the existence of protocols were collected. Their usual practice of sedation and intubation, training and proposals for changes were noted. Results The study was made through all of the 64 public hospitals of Ile de France.

All of the 96 EPs called responded. The median of ETI declared was Predictive criteria for difficult ETI cited the most were: short neck, obesity, small mouth opening and otorhinolaryngology disease or previous history of cervical radiotherapy.

Seventy-seven percent proposed to spend time in the operating room to improve their practice of ETI. It should be part of the EP curricula and written procedures should be made. Introduction Incorrect positioning of the endotracheal tube ETT within the airway after emergent intubation can result in serious complications.

Accidental mainstem bronchus intubation is associated with contralateral atelectasis, tension pneumothorax, hypotension, and decreased survival.

Conversely, failure to place the tube several centimeters beyond the vocal cords may result in inadvertent extubation, aspiration, pneumonia, or laryngeal spasm [1]. The aim of this study was to investigate the occurrence of ETT malpositioning after emergency intubation in the out-of-hospital setting. Methods A retrospective study of a 5-year time period, using records of 1, patients admitted to the trauma emergency room ER at a university hospital.

Within 30 minutes after admission, a chest X-ray or whole-body CT scan was routinely performed in intubated patients to determine the tube-tip-carina relationship. Results Sixteen out of 1, patients died immediately after admission to the trauma ER and were not further radiologically diagnosed. Of the surviving 1, patients, In the group of intubated patients, Chest X-ray scans were not available for 53 patients Detailed data on ETT placement were available in patients; Of patients, had been intubated preclinically on scene Conclusions This study clearly shows that ETT misplacement in emergency patients is still a serious problem with an incidence of We conclude that the skill level of the operator may be key in determining efficacy of endotracheal intubation.

Based on our findings, all efforts should be made to verify the tube position with immediate radiographic confirmation after admission to the ER.

Anesthesiology , Does bedside chest ultrasound in the ICU improve early diagnosis and quick resolution of pleural effusion? Introduction A bedside chest ultrasound bCUS programme S2 performed by intensivists after 18 months of training was. Methods The procedure was performed within the first 24 hours after admittance.

All of the 92 patients were examined supine, with the probe perpendicular to the chest wall, using all of the intercostal spaces as the acoustic window.

With this technique, once we identified the lung's base, we looked for signs of PE according to the following criteria: a space between the two pleural layers; b variation in the interpleural distance of this space during breathing.

For each patient the following data were collected: age, sex, weight, height, SAPS II, number of chest drains, number of ultrasound scans performed, number of significant PE at least 2 cm of width between the two pleurae , amount of ultrasound-guided drainage actually performed within the first 24 hours, timing of resolution of PE.

A total of 59 PEs for which drainage proved to be useful were found. An amount of 27 pleural drainages were performed within the first 24 hours.

We have no evidence of complications. All of the positive cases for PE have been successfully treated. All drainage was performed within the first 24 hours or at least within the first 48 hours. Conclusions Compared with the control group As far as PE is concerned, the introduction of bCUS performed by intensivists in the ICU daily routine determines an increase of early diagnosis and treatment. However, the increase in the number of the first-day treatments was not significant since this procedure is now turning from a purely diagnostic approach into an operative one.

This will necessarily need time. Portable chest radiography in mechanically ventilated ICU patients: does synchronizing with end-inspiration improve the quality of films?

The inability of sedated, ventilated patients to hold their breath during CXR will also affect the degree of lung inflation and contribute to lack of correlation between serial CXR changes and clinical status [1]. We studied the effect on CXR quality by manually synchronizing the ventilator to end-inspiration in mechanically ventilated ICU patients.

Intubated post-elective surgical patients were excluded due to the high likelihood of normal lungs. The control film was taken in the. For the synchronized film, the investigator wore a lead apron and dosimeter, stood 1 to 1. The sequence of the paired films was computer-randomized. The ventilator model, settings, patient position and portable X-ray machine settings were kept constant between films. Patients served as their own controls.

Linear regression, taking two radiologists' scores of each patient into account, was used to examine whether there were any differences in the criteria ratings between random and synchronized films. Radiologists and statistician were blinded. Results We recruited patients; there were no complications from the breath-hold maneuver. Dosimeter readings were negligible. Conclusions Synchronizing the CXR to end-inspiration improves the quality of the film and is safe. Effect on the appearance of bedside chest radiographs in mechanically ventilated patients.

Quality assurance report on the use of continuous positive airway pressure and end-tidal carbon dioxide during respiratory distress in field emergency care. Introduction The use of continuous positive airway pressure CPAP is beneficial in the hospital and home care environment. It is used to support ventilation during neurological disease, ventilatory defects, congestive heart failure and obstructive sleep apnea. Field emergency medicine has inherent complications for the delivery and monitoring of patients receiving CPAP.

We completed an internal quality audit to determine whether CPAP had benefit and whether capnography could be comfortably used in parallel with a CPAP device to monitor ventilation. Methods The data collection was completed on patients with respiratory distress. Patients were monitored with capnography and pulse oximetry.

Emergency Medical Services and Emergency Department staff evaluated acceptance and ease of use of the equipment. A one-tailed paired test and descriptive statistics were completed. Results Eighteen respiratory distress patients received CPAP: eight female, nine male and one patient had missing data sex entry was blank. Mean age was 79 years. The emergency medical technicians found the devices, CPAP, mask, and etCO2, easy to use, and 16 patients ranked it comfortable.

Two patients were uncomfortable with CPAP. Conclusions CPAP in field emergency medicine can be easily applied, is well tolerated, and results can be monitored by capnography. Capnographic measurements indicated improved ventilation by a decrease in carbon dioxide. CPAP and etCO2 can be used in field emergencies to support and monitor ventilation during respiratory distress.

Cardiogenic oscillations extracted from spontaneous breathing airway pressure and flow signal are related to chest wall motility and continuous positive airway pressure. Introduction During mechanical ventilation, signal pulses within pressure and flow curves can be observed that are related to the activity of the beating heart. From a signal-processing view, these cardiogenic oscillations COS can be understood as repeated pulses that are transferred via the lungs and airways to the airway opening.

It was demonstrated earlier that COS, achieved during breath-holding maneuvers, were influenced by changes in mechanical properties of the thorax [1]. We hypothesized that these COS can be extracted from the airway pressure and flow signal during spontaneous breathing.

Furthermore, we hypothesized that these isolated signals contain information about the mechanical properties of the respiratory system.

Airway pressure and flow as well as an electrocardiogram were recorded at a sample frequency of Hz. To isolate the signals that are related to the activity of the heart, pressure and flow data were aligned in time to the R-wave of the QRS complex and averaged.

Results Highly characteristic pressure and flow oscillations could be extracted from the spontaneous breathing signals. Conclusions COS can be extracted from the airway pressure and flow signal during spontaneous breathing.

They contain information about the mechanical properties of the respiratory system. After further investigations, our new method potentially allows an estimation of compliance of the respiratory system during spontaneous breathing. J Appl Physiol , Introduction Respiratory failure is a common indication for admission to a pediatric intensive care unit PICU.

Tracheal intubation and invasive ventilation carries some risk and can contribute to morbidity and possible mortality. Noninvasive positive pressure ventilation NIPPV is a mode in which ventilation is applied without tracheal intubation but via nasal prongs or a face mask. We hypothesized that using NIPPV in infants with pending respiratory failure may improve their outcome. Methods In this prospective study, we enrolled infants admitted with pending respiratory failure to the PICU.

Vital signs, ventilator settings and laboratory results were recorded electronically.

records of 1, patients admitted to the trauma emergency room. (ER) at a university hospital. Holanda-Peña M, López-Espadas F: Safety and complica- . tions of reaction of the observed alveoli is, thereby, recorded by video. endoscopy. J Beneš, I Chytra, P Altmann, M Hluchy, E Kasal, R Sviták, R. Pradl, M. 19Lassnigg, A, Schmid, ER, Hiesmayr, M et al. Impact of minimal increases in serum Benes, J, Chytra, I, Altmann, P et al. Intraoperative fluid optimization. 'View full abstract' or 'Access slides & videos online' M.E. Esquerro, R. Zamora, D. Caruso, E.R. Perna, C. Engel, M. Manzotti, P. Bujanda Morun, P. Pena Ortega, V. Quevedo Nelson, H. Mendoza Lemes, Chytra K. top 8 most popular pci video graphics card ideas and get free shipping · ConsumerElectronics · best top men watch fitbit list and get free shipping · top 10 board. Microcirculatory videos were done before surgery, at least 15 minutes after initiation of pneumoperitoneum Conclusion Kup er cells played a crucial rule in modulating J Benes, J Zatloukal, A Simanova, I Chytra, E Kasal L Sayagues1, J Sieira1, E Abbu2, J Chico3, C Pena3, J Gonzalez Juantey2.

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